Gov. Haslam says no to Tennessee Medicaid expansion

Document: Haslam news release

NASHVILLE - Republican Gov. Bill Haslam today said he will not pursue an expansion this year of the state's version of Medicaid, called TennCare, under the federal health care law.

In an address to a joint convention of the General Assembly, Haslam blamed the Obama administration for problems related to the Affordable Care Act, or Obamacare.

But he said he is continuing to work on a plan that he believes would enable Tennessee to add an estimated 170,000 low-income residents to a plan that provides private insurance. The federal government hasn't accepted that proposal.

"Without bold reform of the Medicaid program tailored to Tennessee's unique situation, there can be no compromise on this issue," he said.

Haslam is among the last of the Republican governors to declare a decision on expansion. Both the health care program and President Barack Obama are widely unpopular in the highly Republican state.

Meanwhile, legislative Democrats lambasted Haslam's decision.

"Gov. Haslam has a 68 percent approval rating and $1 billion and he's afraid of the fringe of his own party," Rep. Mike Stewart, D-Nashville, charged following Haslam's announcement today before a joint convention of the General Assembly.

House Minority Leader Craig Fitzhugh, D-Ripley, said the governor is leaving a $1 billion a year for the next three years "on the table that would provide insurance for working Tennesseans. I think that's the bottom line."

Recognizing the problems he would have with his own party in the Legislature through a straight expansion of Medicaid, Haslam has been working for months on another way to do it.

The governor wants to follow the lead of governors in Arkansas and Ohio, who want to use the money to "buy" the expansion population onto the health care exchanges that are also being created under the law.

The governor later told reporters that U.S. Health and Human Services officials would not provide him and TennCare Director Darin Gordon definitive answers on several key provisions in Tennessee's proposal. Haslam wants to put the Medicaid expansion population on the exchanges, where they could buy private insurance.

But Haslam also wants them to get the same benefits, not more as they would under Medicaid, as others on the exchanges.

He also wants to reform the payment structure for providers where they are compensated for health outcomes and not just for services provided.